Legion: Treatment for PTSD and TBI 'limited and inadequate'

Oct. 2, 2013 - 04:35PM
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The nation’s largest veterans group says the Veterans Affairs Department and Pentagon are not doing enough to treat veterans with post-traumatic stress disorder and traumatic brain injury.

Calling current medical protocols and treatments at VA and DoD “limited and inadequate,” the American Legion urged the two departments to provide more non-pharmaceutical care and invest research dollars in complementary and alternative medical therapies such as acupuncture, yoga and biofeedback.

In a new report, a seven-member Legion committee largely found that DoD and VA have “no well-defined approach to the treatment of TBI” and veterans who seek care at VA for PTSD are 2½ times more likely to be prescribed opioid pain medications than those experiencing chronic pain.

“The fact that there is an emphasis on drugs as opposed to other treatments, that these guys and gals are going in there with issues and the answer is to prescribe them drugs, is incredible. There are alternatives,” said William Detweiler, chairman of the panel that drafted the report, titled “The War Within,” and a past national commander of the American Legion.

The report advocates for research on non-medical alternative care and medical treatments such as hyperbaric oxygen therapy, or HBOT, for traumatic brain injury, a therapy currently under study in DoD.

The first two of four DoD-sponsored HBOT studies have found no significant benefit from using pressurized oxygen on troops with persistent symptoms of mild traumatic brain injury. But Detweiler said more independent study must be undertaken, not only with HBOT but other treatments such as acupuncture.

“To some extent, I wonder if these studies are tainted before they start,” Detweiler mused, discussing the pressure he believes physicians and the government feel from pharmaceutical companies that manufacturer psychiatric and pain medications. “We need to get the wolf out of the hen house and have independent studies on these therapies.”

In addition to pressing for more research, the report suggests DoD and VA collaborate on improving the Transition Assistance Program and accelerate development of electronic medical records to facilitate a “warm hand-off” between the Pentagon and VA as troops leave active duty.

Jacob Gadd, American Legion deputy director for health care, said that as combat deployments wind down, his organization will continue to focus on pressing health care needs of post-9/11 veterans, including mental and physical health, treatment for female veterans and long-term care.

“We understand the relationship between the budget and priorities, but this should be a priority for VA as well as lawmakers to make advances in these fields,” Gadd said.

The report suggests that Congress pressure DoD and VA to accelerate research and ensure that the departments work with private-sector researchers to discover new treatments. It also recommends Congress provide additional funds for research and calls for better oversight within VA and DoD of patients’ medications.

The seven-member committee that drafted the report includes a retired Army colonel who served on the Joint Staff Wounded Warrior Integration Team and a public health researcher at Columbia University, but no medical personnel.

Detweiler said committee members visited military, VA and private medical facilities, read previous reports and studies, and interviewed many patients, caregivers and doctors to develop the findings.

“We have to keep these concerns on the front burner and ensure that VA and DoD have appropriate funding to provide the appropriate treatments of these veterans,” he said.